As you consider the number of residency programs to apply to, you should do so in light of your complete application and personal circumstances. But you may not know where to start the process.

So researchers at the AAMC conducted a study with the goal of helping anchor your initial thinking about the optimal number of applications. They wondered if there was a point at which the relationship between the number of applications submitted and the likelihood of entry into residency changes. The researchers investigated whether there is a point of diminishing returns—a point at which the value added by submitting one additional application is reduced relative to the value added by each application before reaching the point of diminishing returns.

Study methodology

The researchers used data from applicants who applied through the AAMC Electronic Residency Application Service® (ERAS®) to residency programs in select specialties from 2011 to 2016. The exceptions are anesthesiology, dermatology, diagnostic radiology, neurology, radiation oncology, and urology, in which researchers used data from applicants who applied from 2011 to 2015.

The researchers used the number of programs an applicant applied to, the applicant’s most recent USMLE Step 1 score, and the applicant’s type (e.g., U.S. MD) to predict whether an applicant entered a residency program in the application year. (For anesthesiology, dermatology, diagnostic radiology, neurology, radiation oncology, and urology, the researchers predicted whether an applicant entered a residency program in either the first or second year after application because some programs in these specialties required a preliminary year.) The study did not differentiate how applicants entered a program (e.g., National Resident Matching Program Main Residency Match, Supplemental Offer and Acceptance Program).

The researchers used a specialized type of regression analysis known as “spline regression” to understand the relationship between the number of programs to which an applicant applied and entry into a residency program.

What the findings tell us

The likelihood of entering a residency program varies by specialty, Step 1 scores, and applicant type. On average, applicants applying to primary care specialties, those with higher Step 1 scores, and those who are U.S. MD applicants (i.e., U.S. MD seniors and graduates) have a higher likelihood of entering a residency program compared with applicants applying to competitive specialties, those with lower Step 1 scores, and those who are U.S. DO, U.S. IMG, and foreign IMG applicants.

There is a point at which submitting one additional applicationresults in a lower rate of return onthe applicant’s likelihood of entering a residency program. This means that the value added by submitting one additional application is reduced relative to the value added by each application before reaching the point of diminishing returns. Note: This point of diminishing returns is an estimate and is not perfectly precise.

The point of diminishing returns varies based on USMLE Step 1 scores. On average, applicants with higher USMLE Step 1 scores require fewer applications to reach the point of diminishing returns compared with applicants with lower USMLE Step 1 scores.

The point of diminishing returns also varies by specialty and applicant type. On average, applicants to competitive specialties had to submit more applications to reach the point of diminishing returns compared with applicants to primary care specialties. The point of diminishing returns was, on average, lowest for U.S. MD applicants compared with U.S. DO, U.S. IMG, and foreign IMG applicants.

Data on the point of diminishing returns are presented separately for the following specialities:

The AAMC is continuing to analyze data on additional specialties and will make reports on the results available over time.

How to interpret and apply the findings

Use these findings as a starting point for considering the number of programs you will ultimately apply to. There is no magic number that applies to all applicants, so consider the point of diminishing returns in the context of your overall residency candidacy and application. Evaluate a wide variety of information—such as your unique experiences, qualifications, and residency application strategy—as you work with your advisor to determine how many programs and which ones to apply to.

How to develop a smart application strategy

Remember, in addition to considering the point of diminishing returns in light of your complete application, to best position yourself, you should:

Well before you approach the time to consider your residency application strategy, focus on becoming the best medical student, future physician, and colleague you can be. These efforts can only help pave the way toward securing residency training.

Training in a Residency or Fellowship

The Association of American Medical Colleges is a not-for-profit association dedicated to transforming health care through innovative medical education, cutting-edge patient care, and groundbreaking medical research. Its members are all 152 accredited U.S. and 17 accredited Canadian medical schools; nearly 400 major teaching hospitals and health systems, including 51 Department of Veterans Affairs medical centers; and more than 80 academic societies. Through these institutions and organizations, the AAMC serves the leaders of America’s medical schools and teaching hospitals and their more than 173,000 full-time faculty members, 89,000 medical students, 129,000 resident physicians, and more than 60,000 graduate students and postdoctoral researchers in the biomedical sciences.